BILL ANALYSIS
AB 2818
Page 1
Date of Hearing: April 18, 2006
ASSEMBLY COMMITTEE ON HEALTH
Wilma Chan, Chair
AB 2818 (Maze) - As Introduced: February 24, 2006
SUBJECT : Maternal use of narcotics: testing.
SUMMARY : Requires the Department of Health Services (DHS), in
consultation with the Department of Alcohol and Drug Programs
(ADP) to conduct a pilot program that would randomly select
twelve health facilities to conduct random drug testing of
mothers and their infants to detect illegal narcotics use.
Specifically, this bill :
1)Requires DHS to randomly select 12 health facilities licensed
as general acute care hospitals that provide obstetric and
neonatal services to participate in the pilot program.
2)Requires DHS to establish protocols for the pilot program,
requiring each participating health facility to conduct random
urine tests of mothers and their infants at birth. Requires
the test to be confidential and undisclosed to the mother and
designed to identify the illegal use of narcotics by the
mother. Requires that if the mother tests positive and the
baby tests negative, that a further test be conducted of the
baby's meconium.
3)Requires DHS to establish protocols for the program that
require the selected health facilities to compile the results
in a statistical report in a manner that does not identify the
mothers or infants tested and require the selected health
facilities to report the results to DHS and ADP, as specified.
4)Requires DHS, in consultation with ADP, to report the
statewide results of the pilot program to the Legislature by
January 1, 2008.
EXISTING LAW :
1)Establishes the Office of Perinatal Substance Abuse (OPSA),
within ADP, to coordinate pilot projects and planning projects
relating to perinatal substance abuse. Requires OPSA to
oversee perinatal alcohol and drug treatment programs.
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2)Allows the establishment of a perinatal coordinating council,
consisting of experts in the areas of alcohol and other drug
treatment, and other drug related fields.
3)Defines a general acute care hospital as a health facility
that provides 24-hour inpatient care, including the following
basic services: medical, nursing, surgical, anesthesia,
laboratory, radiology, pharmacy, and dietary services.
FISCAL EFFECT : Unknown
COMMENTS :
1)PURPOSE OF THIS BILL . According to the author, this bill is an
effort to establish a public health surveillance system that will
alert state and local policymakers to changes in drug abuse
patterns among women giving birth in California hospitals. The
author points out that there is a lack of reliable data on drug
abuse patterns among pregnant and parenting women, and the rates
of drug exposure and the types of drug exposure among newborns in
California. There should be a tracking system for drug use and
drug exposures similar to the data tracking of West Nile virus,
HIV, and other potentially deadly infections.
2)BACKGROUND . According to OPSA, there are approximately 300
publicly-funded perinatal alcohol and other drug treatment
programs that annually serve over 38,000 pregnant and parenting
women, and their children. The aim of OPSA includes empowering
women to achieve and maintain clean and sober living, deliver
healthy infants, strengthen family units, and lead productive
lives. Perinatal services are designed to be gender specific and
culturally relevant, and include outpatient drug-free, daycare
rehabilitative, residential treatment, narcotic replacement
therapy, transitional living centers and alcohol and drug-free
housing.
3)DRUG MEDI-CAL (DMC) . ADP receives Medi-Cal funding from the DHS
for eligible services provided to Medi-Cal beneficiaries through
an Interagency Agreement. DMC benefits are optional Medi-Cal
benefits. DMC services provide medically necessary alcohol and
other drug treatment to eligible Medi-Cal recipients. The
services include Outpatient Drug Free Treatment, Narcotic
Treatment Program and Naltrexone Treatment. In addition, Day Care
Rehabilitative Treatment and Residential Treatment are available
to full scope Medi-Cal beneficiaries under the age of 21 and to
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pregnant and postpartum women.
4)PROPOSITION 36 . In 2000, California voters approved Proposition
36 or the Substance Abuse and Crime Prevention Act of 2000
(SACPA), which requires probation and drug treatment instead of
incarceration for individuals convicted of possession, use,
transportation for personal use, or being under the influence of
controlled substances and similar parole violations, but not for
the sale or manufacture of drugs. Eligible offenders receive up
to one year of drug treatment and six months of after care. In
2001, SACPA appropriated $120 million to be distributed to
counties to provide drug treatment and other services. Funding is
subject to terminate after FY 2005-2006, however, the Governor's
2006-2007 budget proposal included a $120 million authorization
for Proposition 36 but conditioned this funding on the Legislature
enacting policy changes relating to improving participant outcomes
and accountability.
5)POLICY STATEMENTS .
a) Constitutionality of drug-testing . This bill requires a
general acute care hospital participating in the pilot program
to conduct random urine tests of mothers and infants at birth
without the consent of the mother. The random testing may
violate the Fourth Amendment of the United States Constitution
which protects a person against unreasonable searches and
seizures. In addition, there are serious privacy concerns
implicated by this bill. This bill may also have a chilling
effect on women seeking healthcare.
b) Purpose of the test . This bill requires the confidential
test to be designed to identify the illegal use of narcotics by
the mother. This bill assumes that when a mother tests
positive for narcotics, the use is illegal. A mother could
test positive as a result of prescribed narcotics.
c) Use of the data . Will the hospitals participating in the
pilot program be required to reveal the information to law
enforcement agencies who wish to prosecute drug-abusing
mothers? When the data is revealed to anyone, should the
consent of the mother be obtained before any data is released?
6)OPPOSITION . Opponents point out that this bill would impede women
from obtaining necessary medical services because of the fear
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associated with random drug testing. Additionally, opponents
state that discussing substance abuse at the onset of a prenatal
visit is important in counseling pregnant women about the
implications of substance abuse during pregnancy. The American
Association of University Women maintains that no tests should be
performed on a woman without her consent and considers this bill
unconstitutional.
REGISTERED SUPPORT / OPPOSITION :
Support
None on file.
Opposition
American Association of University Women
American Civil Liberties Union
American College of Obstetricians and Gynecologists, District IX
California Medical Association
Maternal, Child and Adolescent Health Directors
Planned Parenthood Affiliates of California
Planned Parenthood Golden Gate
Analysis Prepared by : Rosielyn Pulmano / HEALTH / (916)
319-2097